Provider Demographics
NPI:1356511364
Name:SPENCER CHIROPRACTIC CENTER, INC P.S.
Entity Type:Organization
Organization Name:SPENCER CHIROPRACTIC CENTER, INC P.S.
Other - Org Name:MCAULEY FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:MCAULEY
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:253-874-9001
Mailing Address - Street 1:32717 1ST AVE S STE 5
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5758
Mailing Address - Country:US
Mailing Address - Phone:253-874-9001
Mailing Address - Fax:
Practice Address - Street 1:1010 S 336TH ST STE 120
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7354
Practice Address - Country:US
Practice Address - Phone:253-874-9001
Practice Address - Fax:253-874-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002673111N00000X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty